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v1.0.0
ICD-10 Guide
ICD-10 CodesQ71.90

Q71.90

Billable

Unspecified reduction defect of unspecified upper limb

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/11/2025

Code Description

ICD-10 Q71.90 is a billable code used to indicate a diagnosis of unspecified reduction defect of unspecified upper limb.

Key Diagnostic Point:

Unspecified reduction defect of the upper limb refers to a congenital malformation characterized by the partial or complete absence of one or more bones in the upper limb. This condition can manifest as a reduction in the size of the limb or the absence of specific structures, leading to functional limitations and aesthetic concerns. The defect may involve the humerus, radius, ulna, or associated soft tissues. The etiology of these defects can be multifactorial, including genetic predispositions, environmental factors, or teratogenic influences during pregnancy. Clinically, patients may present with varying degrees of limb functionality, and the condition can be associated with other congenital anomalies, such as syndromes affecting limb development. Early diagnosis and intervention are crucial for optimizing functional outcomes, which may include surgical reconstruction, prosthetic fitting, and physical therapy. Accurate coding is essential for appropriate management and reimbursement, as well as for tracking epidemiological data related to congenital limb defects.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation and severity of limb reduction defects.
  • Potential association with other congenital anomalies or syndromes.
  • Need for precise documentation of limb involvement and functional impact.
  • Differentiation from other congenital conditions affecting the musculoskeletal system.

Audit Risk Factors

  • Inadequate documentation of the specific limb affected.
  • Failure to note associated congenital anomalies.
  • Misclassification of the defect severity.
  • Lack of clarity on functional limitations.

Specialty Focus

Medical Specialties

Pediatrics

Documentation Requirements

Detailed clinical notes on the child's growth, development, and functional abilities related to the limb defect.

Common Clinical Scenarios

Assessment of limb function in a child with a congenital limb reduction defect during routine pediatric evaluations.

Billing Considerations

Consideration of developmental milestones and the impact of the defect on daily activities.

Genetics

Documentation Requirements

Genetic testing results, family history of congenital anomalies, and any syndromic associations.

Common Clinical Scenarios

Genetic counseling for families with a history of limb reduction defects or associated syndromes.

Billing Considerations

Understanding the genetic basis of limb reduction defects and their potential inheritance patterns.

Coding Guidelines

Inclusion Criteria

Use Q71.90 When
  • Follow official ICD
  • CM guidelines for coding congenital malformations, ensuring accurate documentation of the condition's specifics, associated anomalies, and any relevant clinical findings

Exclusion Criteria

Do NOT use Q71.90 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

20670CPT Code

Arthrocentesis, aspiration and/or injection into a major joint or bursa

Clinical Scenario

Used in conjunction with limb reduction defect management for joint-related issues.

Documentation Requirements

Document the indication for the procedure and any findings.

Specialty Considerations

Orthopedic specialists may perform this procedure for associated joint complications.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of congenital conditions, improving the granularity of data collection and enhancing the ability to track outcomes and resource utilization.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of congenital conditions, improving the granularity of data collection and enhancing the ability to track outcomes and resource utilization.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of congenital conditions, improving the granularity of data collection and enhancing the ability to track outcomes and resource utilization.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What is the significance of coding Q71.90 accurately?

Accurate coding of Q71.90 is crucial for ensuring appropriate management and reimbursement for patients with congenital limb reduction defects. It also aids in the collection of epidemiological data, which can inform future research and healthcare planning.